Metabolic syndrome in type 1 diabetes using IDF guidelines
S Santosh, D Santosh & P Evans
Metabolic syndrome (MS) is associated with a two-fold increase in risk of cardiovascular disease and a five-fold increase in risk for diabetes.
The aim of our study was to determine the prevalence of MS in patients with Type 1 diabetes using the latest IDF criteria and evaluate any correlation between MS and daily insulin dosage.
Seventy-five patients (44 males, 31 females; mean age 43 years; age range 1973 years) with type 1 diabetes attending annual review clinics were studied. Waist circumference, blood pressure, total daily dose of insulin and fasting lipid levels were documented. Patients with MS were identified according to IDF criteria.
Twenty-five (58%) males and 24 (77%) females had a waist circumference >94 cm and >80 cm respectively. All patients satisfied the glycaemic threshold by having type 1 diabetes and needed one other factor to satisfy the definition of MS. Thirty-eight patients (50.6%) with MS (22 males and 16 females) were identified. The commonest additional risk factors were hypertension (29 patients, 76.3%), elevated triglycerides (12 patients, 31.6%) and reduced HDL-cholesterol (12 patients, 31.6%).
The average insulin requirement was significantly greater (P=0.03) in patients with MS (62±22 units) compared to those without MS (52±20 units).
It has been shown, by using ATP III NCEP criteria the prevalence of MS in patients with type 1 diabetes was 16% (Al-Saraj et al. 2004). We have demonstrated a greater prevalence (50%) of MS in patients with Type 1 diabetes using the updated IDF criteria. Waist circumferences in the MS group with type 1 diabetes positively correlates (r=0.50) to the total daily dose of insulin taken by these patients. The combination of hypertension, reduced HDL cholesterol and elevated triglyceride levels carries an increased vascular risk and should be aggressively treated when found in patients with type 1 diabetes.